Clinical Features

The initial lesion appears 2-3 months after inoculation. It occurs in nasopharyngeal mucosa at the site of inoculation. There is a papule or painless ulcer accompanied by regional adenopathy. Secondary lesions last 6-9 months. They are composed of a macular or papular eruption with multiple erosive and crusty lesions that predominates in the limbs. There can be anogenital condylomata. There is generalized adenopathy, and there can be osteoperiostitis of the long bones that causes nocturnal pain. Tertiary lesions appear 6 months to several years after the primary lesion.They appear in the nasopharynx, larynx, skin and bones. They are destructive gummas that ulcerate and leave atrophic scars, often geometrical. Lesions of the palate and nose are destructive and disfiguring. There is also syno-vitis, uveitis, choroiditis and chorioretinitis.

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